Tips or tricks for lowering fasting morning glucose levels without resorting to insulin?

May 15, 2006 10:05 AM

Tips or tricks for lowering fasting morning glucose levels without resorting to insulin?

Yes, yes, I know ... see my doctor, etc. etc. etc. I'm getting quality medical care, I just want more opinions, and maybe some non-traditional approaches.

Short form: I may or may not have gestational diabetes. My 1 hour and 3 hour glucose tollerance tests were extremely high, but there is some debate as to whether the after effects of a recent severe illness may account for some of that.

My blood glucose levels are fine during the day (always below 120 tested 2 hours postprandial, provided I don't eat anything stupid) but when I test in the morning my levels are between 102 - 115 (most often 107). If I'm not able to drop those morning fasting levels down to about 95 in the next few days, I'm going to have to start taking insulin in the evenings, with the end result that I'll have to leave my current midwife's practice and get an OB and give birth at a hospital rather than at the birth center where I'm currently a client. I'm pretty desperate to avoid this if at all possible.

My diabetes councelor has advised me to try eating a snack directly before bed that is mainly protein (peanut butter or chicken, etc), and exercising right before bed. I'm going to do both of these, but was wondering if any diabetic or medical type metafilter folks had any other suggestions, either for diet suppliments or other diet-related approaches that have worked for them.

I am currently adding 1 teaspoon of cinnamon to my diet daily as seen in this study and it does seem to help...

posted by anastasiav to health (10 comments total)

I'm no doctor, but I am diabetic, and I'd second-guess some of what you're being told. Your blood glucose levels are a little high for a non-diabetic, but they're very low for a diabetic. You seem to be borderline. I'd say you don't have gestational diabetes. You may or may not be in the process of developing gestational diabetes. You should look at the trends over time to see if your levels are changing, or if you're just someone who is regularly a little high.

I don't know much about dietary needs during pregnancy, but the advice to eat before bed sound like bad advice from a diabetes perspective. Bodies don't break down food as well during sleep, so if you don't want to have a bunch of glucose floating around, not broken down, you should eat earlier so that it all gets broken down before you sleep. High-protein foods still have carbohydrates, which is what produces the glucose. I think better advice would be to eat low-carbohydrate foods earlier, and avoid eating directly before bed at all.

Exercise may or may not help, depending on how close to diabetic you are. When you exercise, your body does two things: it releases reserve energy as glucose for muscles to use and it releases insulin to break down that glucose so the muscles can actually use it. Whether or not your body is releasing more insulin than glucose depends on how close to diabetic you already are. When I exercise, my blood glucose level can often go up, because my body is releasing more energy for my muscles to use, but no insulin to break down that energy.
posted by scottreynen at 10:30 AM on May 15, 2006

I am a gestational diabetic, with my diabetes being overseen by specialists and a leading perinatologist. To scottreynen: gestational diabetes is treated a bit differently than you are familiar with. Morning values above 95 are considered high for a pregnant woman, and blood sugar levels that may seem low to you can lead to complications during pregnancy and after.

Anastasiav, so sorry this has come up. My understanding about the night snack is that it does help stabilize your blood sugars a little bit, but my morning values have been good and I haven't had to worry about that. Just make sure you are waiting 10-12 hours before you test for fasting levels.

As anecdotal advice, I was able to bring my sugars down significantly with exercise. You may want to try exercise during the day as well as after your last meal. This seemed to help with my overall ability to keep sugar levels down.

I wish I had other diet advice to give you. It's been my impression that there's not a whole lot you can do about fasting values.

If you have any questions or need to commiserate, my email address is in my profile.
posted by moira at 10:52 AM on May 15, 2006

Morning glucose levels are a bitch, because your body is busily dumping extra glucose into your system as you sleep. (This is true for everyone.) High morning numbers can sometimes come from low blood sugar in the night, and the best remedy will depend on what's going on with your system overnight. Have you ever tried waking up at 2 or 3 in the morning and testing your glucose levels then? If your blood sugar is high(ish) all night, then the plan with the exercise and protein-only snack may well help -- it's a standard recommendation for that state of affairs.

But if your blood sugar is dropping quite low in the night, your morning highs may be coming from a rebound effect, where your liver is releasing even more glucose than normal in an attempt to rectify hypoglycemia. In that case, you may have better luck with small snacks just before bed that include protein and just a bit of carb to raise your glucose level sufficiently that your liver chills out -- so peanut butter on a whole-wheat cracker, for instance.

Not morning-effect specific: eating lots of fiber also helps regulate blood sugar. And my husband, who has type-2 diabetes, finds that exercise is extremely good for his blood glucose levels, but it helps more over the long term rather than otherwise -- his levels are better during weeks where he gets plenty of exercise, rather than being specially better a couple of hours after he works out.
posted by redfoxtail at 10:54 AM on May 15, 2006

Nursing student here. Moira is right on about the pre-bedtime snack: it is important because the timing of the snack, and combination of protein and complex carbohydrates help prevent hypoglycemia at night.

Sorry I don't have any more to add. Good luck with your diet and exercise plan.
posted by dog food sugar at 11:17 AM on May 15, 2006

Thanks for the answers so far, I look forward to more...

One questions does come up -- is it better to eat, then exercise, then sleep, or exercise, then eat very last thing before I go to bed? Or does it matter?
posted by anastasiav at 11:25 AM on May 15, 2006

Exercise after meals when blood sugar levers are high - according to my text book. Ask your diabetic councelor about exercising around the pre-bedtime snack. That's a good question.
posted by dog food sugar at 11:42 AM on May 15, 2006

Ugh. That's blood sugar levels... sorry.
posted by dog food sugar at 11:43 AM on May 15, 2006

I wish there were blood sugar levers :-)
posted by anastasiav at 12:08 PM on May 15, 2006

I think redfoxtail has a good point. When you exercise (and what you eat before bed) could depend on what your sugars are doing during the night. If it stays up all night, it might be best to exercise after eating that last snack. If your sugars drop and rebound, you might want to exercise in the morning, before testing.

That's for that particular value. General daily exercise might bring everything down a bit for you, as it did for me. I included both resistance and aerobic exercises.
posted by moira at 12:22 PM on May 15, 2006

Also a diabetic here, although I am on insulin (40 units of Lantus injected in the early evening, usually pre-evening meal). Even with that, a long acting 24 hour insulin, I still have a snack at bedtime and my glucose levels are still sometimes out of whack in the mornings.

I have to get up early, so my early morning test is done at about 5am. If I get a high reading, I test about an hour after I get to work (7-ish) and they are usually fine by then. My bedtime snack usually consists of a glass of milk and something like a couple of sugar free cookies, sugar free youghurt with some peanuts in it (sounds weird, but not bad!) or very occassionally some sugar free ice cream.

I exercise 30 - 40 minutes on the treadmill when I get home from work 5 days a week and that usually works for me - although in your condition that might not be so easy. What meds do you take? It might make a difference in the timing of those also. Take a look at WebMD, they used to have some pretty good forums on there for diabetics.

Best of luck, hopefully you won't need to go the insulin route!
posted by 543DoublePlay at 4:43 AM on May 16, 2006